氨甲环酸术前静脉滴注联合术中关节内注射对TKA围术期失血量的临床研究

A clinical study of the effect of preoperative intravenous drip combined with intra-operative intra-articular injection of tranexamic acid on the blood loss during the perioperative period of TKA

目的探讨氨甲环酸术前静脉滴注联合术中关节内注射对TKA围术期患者失血量情况的效果。方法选取我院2017年11月~2020年3月收治68例TKA治疗的患者,根据随机数字表法分为对照组和实验组,各34例,术前给予两组患者氨甲环酸静脉滴注,实验组则在手术中增加关节腔内注射。对比分析两组的并发症情况、围术期失血量、引流量与膝关节功能等情况。结果实验组的围术期失血量、引流量与并发症总发生率低于对照组;两组患者治疗后的膝关节功能评分均高于治疗前,且比照对照组,实验组更高;差异有统计学意义(P <0.05)。结论对TKA患者使用术前氨甲环酸静脉滴注联合术中关节内注射治疗具有理想效果,可减少患者围术期失血量、引流量,减少并发症发生率,可以提高其膝关节功能,临床上值得推广应用。

Objective To investigate the effect of preoperative intravenous drip combined with intra-operative intra-articular injection of tranexamic acid on the blood loss of the patients during the perioperative period of total knee arthroplasty(TKA).Methods A total of 68 patients treated with TKA in our hospital from November 2017 to March 2020 were selected and divided into the control group and the experimental group with 34 patients in each group according to the results of random number table.The two groups of patients were given an intravenous drip of tranexamic acid before the operation,while the experimental group received intra-articular injection during the operation.The complications,the perioperative blood loss,the drainage volume and the knee joint function,etc.of the two groups were compared and analyzed.Results The perioperative blood loss,the drainage volume and the total incidence of complications of the experimental group were lower than those of the control group.The knee joint function scores of the two groups of patients after treatment were higher than those before treatment,and compared with the knee joint function scores of the control group after treatment,those of the experimental group were higher.All the above-mentioned differences got from the comparisons were statistically significant(P<0.05).Conclusion Preoperative intravenous drip combined with intra-operative intra-articular injection of tranexamic acid produces an ideal effect on the patients receiving TKA.It can reduce the patients’perioperative blood loss and drainage volume,lessen the probability of complications,and improve the knee joint function.It is worthy of clinical promotion and application.